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Kentucky Department of Agriculture Revised 01/2018

2018 Processing/Handling Organic System Plan

Please fill out this questionnaire if you are requesting organic process/handling certification or re-certification. Attach Organic Product Profile sheets for all products requested for certification and a current

schematic product flow chart, Organic Control Points, facility map, pest management map, water test, and appropriate MSDS if required. Use additional sheets if necessary.

If completing this form electronically, select check boxes by double clicking. Renewal Deadline – March 1

SECTION 1: General Information

Applicant/Company Name Organic Certification Number if Renewal

Owner Manager Primary contact person

Year Company Began:

Number of Employees:

For Office Use Only

Received

Name of person overseeing organic production: Entered Initials

Do you have an employee training program for organic product permits, processing or handling? yes no

Fee/Check Number Amount

Government permits/inspections: Year first certified:

Type of processing handling:

Primary Contract vendor

Estimated annual total production($): ________________

______% Organic

______% Conventional

Are any products produced as both certified organic and non organic? yes no

List all products requested for organic certification. Attach an Organic Product Profile for each individual product.

SECTION 2: Assurance of Organic Integrity

NOP standards require that procedures, processes, storage and equipment present no contamination risk to organic products from co-mingling with other non-organic products, sanitation products or pest management products. Procedures used to maintain organic integrity must be documented.

ORGANIC CONTROL POINTS: (OCP’s), similar to Hazard Analysis Critical Control Points (HACCP), are points in the production system where the integrity of the organic product may be compromised. Examples are co-mingling with non-organic products, contamination by sanitizers or pesticides, and improper cleaning of equipment prior to running organic products.

An application without a written organic control point plan will be considered incomplete.

Do you have an Organic Control Point program in place to address areas of potential contamination? yes no

Has the OCP document been attached? yes no

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SECTION 3: Material Inputs

NOP standards require that all primary ingredients be certified organic unless they are not available. Salt and water are not considered ingredients. Non-organic ingredients and processing aids must be listed as Approved on the National List. You also need to show efforts to obtain certified organic ingredients whenever possible. No genetically engineered ingredients or processing aids are allowed.

Products to be Certified

***Labels and Product Profiles MUST be Included***

Product Name (brand if

applicable) Label Claim (100%

Organic, Organic, Made with Organic)

Size(s) Label Attached?

Product Profile Attached?

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A. INGREDIENTS:

Fill out Organic Product Profiles for all organic products requested for certification.

Are any non-organic ingredients listed as: restricted materials? yes no prohibited materials? yes no

Check if any non-organic ingredients have been processed with or exposed to the following:

irradiation genetic engineering fumigation petroleum distillates synthetic solvents

B. PROCESSING AIDS:

1. List all processing aids used in the production of certified organic products:

2. How/why are they used?

3. Are any processing aids listed as: Restricted materials? yes no Prohibited materials? yes no

4. Check if any processing aids have been processed with or exposed to the following:

irradiation genetic engineering fumigation petroleum distillates synthetic solvents

C. WATER:

Organic standards require that water meet potable water standards. For products that use culinary steam, boiler additives may not contaminate the organic products.

1. Check ways water is used in processing: None used

ingredient processing aid cooking cooling product transport

cleaning organic products cleaning equipment other

2. Source of water: municipal on-site well other

3. Is the water potable? yes no Attach copy of water test, if applicable.

4. List any known water contaminants:

5. What on-site water treatment processes are used? None used

6. Is culinary steam used in the processing of organic products? yes no

7. If steam has direct contact with organic products, do you use: No direct contact

steam filters condensate traps testing of condensate testing of finished products

other (please explain)

8. List products used as boiler additives: Attach MSDS, label information

9. Describe your water conservation strategies?

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SECTION 4: Production System

NOP standards require attachment of a complete written description, or schematic product flow chart which shows the movement of all organic products, from incoming/receiving through production to outgoing/shipping. All equipment and storage areas must be identified.

A. PRODUCT FLOW:

Attach a schematic product flow chart which shows where and how the product is received, stored, processed, packaged, and warehoused, identifying all pieces of equipment, storage areas and where ingredients are added or processing aids used.

B. EQUIPMENT: List all equipment used in processing:

NAME CAPAC ITY

DOES CLEANING OCCUR PRIOR TO ORGANIC

PRODUCTION? YES (Y) OR NO (N)

IS CLEANING DOCUMENTED?

IS THIS EQUIPMENT PURGED PRIOR TO ORGANIC PRODUCTION?

YES (Y) OR NO (N)

If equipment is purged, list and describe purge procedures, quantities purged, and documentation:

SECTION 5: Audit Control and Record Keeping System NOP Rule 205.103

NOP standards require that audit control records track finished organic products back to all ingredients. Ingredients must be verified as certified organic. Amounts of organic finished products must balance with certified organic ingredients purchased. All relevant documents must identify products as “organic.”

NOP Rule requires that records disclose all activities and transactions of the operation, be maintained for 5 years, and demonstrate compliance with the NOP Rule. All records must be accessible to the inspector.

1. Please list all documentation in sequence retained by you from incoming ingredients/products to final product shipping.

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2. Describe your lot numbering system:

3. Can your record keeping system track the finished product back to all ingredients? yes no

How?

4. Can your record keeping system compare organic product sold against organic ingredients purchased?

yes no

SECTION 6: Quality Assurance

1. Do you have a QA program in place? yes no

If yes, what program do you use? HACCP TQM other

2. Are any outside quality assessment services used? yes no

If yes, name of company:

3. Product testing: (check all applicable categories)

ingredients prior to purchase ingredients upon receipt during production finished product

a. What testing is conducted (sanitizer residue, biological, GMO, etc.)?

4. Are ingredient samples retained? yes no If yes, how long?

5. Are finished product samples retained? yes no If yes, how long?

6. Do you have a product recall system in place? yes no

SECTION 7: Sanitation

NOP standards require that good sanitation practices are used throughout the facility and that residues from cleaning materials do not contaminate organic products.

If a detailed cleaning and sanitation manual exists it may be submitted rather than completing this section; it must answer all questions fully.

1. Check all cleaning methods used:

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sweeping scraping vacuuming compressed air manual washing

clean in place (CIP) steam cleaning sanitizing other

2. What sanitizer(s) is used for contact surfaces and equipment coming in direct contact with organic products?

3. Describe the sequence of products and methods used in the cleaning/sanitizing program of these surfaces?{i.e. Cutting Boards: Super Soap, scrub brush, clean water rinse, Sanitizal PPA}

4. Provide information on your cleaning program and products used:

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AREA TYPE OF CLEANING EQUIPMENT USED PRODUCTS USED FREQ DOCUMENTATION

RECEIVING AREA

INGREDIENT STORAGE

PRODUCT TRANSFER

PRODUCTION AREA

PRODUCTION EQUIPMENT

PACKAGING AREA

FINISHED PROD.

STORAGE

LOADING DOCK

BUILDING EXTERIOR

ACCIDENTAL SPILLS

5. Are all surfaces which contact organic products food grade? yes no

6. Do you test food contact surfaces or rinsate for cleanser/sanitizer residues? yes no

If yes describe.

7. Where are cleaning/sanitizing materials stored?

Attach MSDS and/or label information for cleansers and sanitizers, if applicable.

8. For all direct contact surfaces, what is the final cleaning/sanitizing step?

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SECTION 8: Pest Management

A. GENERAL INFORMATION:

1. What type of pest management system do you use?

in-house: name of responsible person:

contract pest control service (name, address, phone no.):

2. Check all pest problems you generally have:

flying insects crawling insects spiders birds rats mice other none

B. CHECK ALL PEST MANAGEMENT PRACTICES YOU USE:

good sanitation removal of exterior habitat/food sources cleanup of spilled product

exclusion sealed doors and/or windows repair of holes, cracks, etc. screened windows, vents, etc.

physical barriers sheet metal on sides of building exterior mowing air curtains air showers

positive air pressure in facility monitoring ingredient inspection for pests

inspection zones around interior perimeter ultrasound/light devices release of beneficials sticky traps

electrocutors pheromone traps mechanical traps scare eye balloons freezing treatments

heat treatments vacuum treatments carbon dioxide nitrogen vitamin baits

pyrethrum ryania rotenone boric acid disodium octal tetrahydrate diatomaceous earth

precipitated silica fumigation fogging crack and crevice spray

other none

C. PESTICIDE USE INFORMATION FOR THE LAST 12 MONTHS:

PRODUCT TARGET PEST

LOCATION WHERE USED

METHOD OF APPLICATION

DATE OF LAST APPLICATION

1. Are any products used which are prohibited by organic standards? yes no

2. Can any pest control products come into contact with any organic ingredients, finished organic products, or packaging materials? yes no

If yes, describe your protocols to prevent contamination:

3. If pesticides are used, where are they stored?

4. Is your structural pest management system effective? yes no

Attach facility map showing location of traps and monitors. Attach MSDS and/or label information, if applicable.

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SECTION 9: Packaging and Labeling

NOP standards require that packaging materials are free of prohibited substances and must not contaminate the organic product. Organic product labels must meet certification agency and government labeling requirements.

A. PACKAGING:

1. Check types of packaging material used: bulk paper cardboard wood glass metal foil

plastic waxed paper aseptic natural fiber synthetic fiber other

2. Are all packaging materials food grade? yes no

3. Are all packaging materials free of prohibited materials? yes no

4. Are packaging materials recyclable? yes no Returnable? yes no

B. LABELING: N/A, I do NOT use labels

Attach samples of all organic product labels. All Labels must be approved before use and must conform to CFR 7 205 Subpart D.

SECTION 10: Storage

NOP standards require that no co-mingling or contamination of organic products occur during storage. All storage sites must be properly documented and organic products clearly identified in storage. Off-site storage areas must be inspected and certified.

STORAGE INFORMATION:

USE LOCATION TYPE/ CAPACITY

DEDICATED ORGANIC?

YES (Y) NO (N) IDENTIFICATION

Ingredient storage

Packaging material storage

In-process storage

Finished product storage

Off-site storage*

* If there is off-site storage, give name, address, phone number and contact person:

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SECTION 11: Transportation of Organic Products

NOP standards require that the integrity of organic products be preserved during transport.

A. INCOMING:

1. In what forms are incoming products received? dry bulk liquid bulk tote bags tote boxes

metal drums cardboard drums paper bags foil bags other

2. How are incoming products transported?

3. Do you arrange incoming product transportation? yes no

4. How do you insure that inbound transport units are clean prior to loading organic products?

Is this documented? yes no

5. Are transport units used to carry any prohibited materials? yes no

6. Have transport companies been notified of organic handling requirements? yes no

7. Are organic products shipped at the same time as non-organic in the same transport units? yes no

8. Check steps taken to segregate organic products: dedicated organic only use of pallets pallet tags

organic product shrink-wrapped separate area in transport unit other

B. IN-PROCESS:

1. How are in-process products transported?

2. How do you insure that in-process transport units are clean prior to loading organic products?

Is this documented? yes no

C. OUTGOING FINISHED PRODUCT:

1. In what form are finished products shipped? dry bulk liquid bulk tote bags tote boxes

paper bags foil bags metal drums mesh bags cardboard drums

cardboard cases plastic crates other

2. How are outgoing products transported?

3. Do you arrange outgoing product transportation? yes no

4. How do you insure that outgoing transport units are clean prior to loading organic products?

Is this documented? yes no

5. Are transport units used to carry any prohibited materials? yes no

6. Have transport companies been notified of organic handling requirements? yes no

7. Are organic products shipped at the same time as non-organic in the same transport units? yes no

8. Check steps taken to segregate organic products: dedicated organic only use of pallets pallet tags

organic product shrink-wrapped separate area in transport unit other

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SECTION 12: Waste Management

1. Will any waste products from certified organic ingredients be sold as certified organic? yes no

If yes, complete Organic Product Profile for each product.

2. Check all aspects of your waste management system that apply: on-site dumpster material recycling

water recycling water filtering composting smokestack filters daily waste pickup

sediment ponds field application of waste other

SECTION 13: Affirmation

I affirm that all statements made in this application are true and correct. I agree to follow organic standards. I understand that the operation may be subject to unannounced inspection and/or sampling for residues at any time as deemed appropriate to ensure compliance with the NOP Rule. I understand that acceptance of this questionnaire in no way implies granting of certification by the certifying agent. I agree to follow the organic standards as required in 7 CFR 205 and KAR 40:010.

I understand that I may withdraw this application in writing at any time. I understand that I may be held liable for the costs of any services provided by the certifying agent up to the time of withdrawal. I understand that my application fee is nonrefundable. I understand that voluntary withdrawal prior to the issuance of a notice of noncompliance or certification denial that I will not be issued a notice of noncompliance or certification denial.

NOTICE OF CONFIDENTIALITY: This information, including any attachments, is intended only for the use of the Kentucky Organic Certification Program, certifying agents, The Kentucky Organic Advisory Board, and required reporting information as required for the Agricultural Marketing Service (AMS) Administrator, National Organic Program. This application may contain information, individual or entity that is of a confidential nature, which is legally privileged and exempt from disclosure under applicable law. Certain information which is considered pubic information may be printed or transferred for marketing and promotional use unless otherwise specified by the signatory. If the reader of this message is not the intended recipient, you are notified that any review, use, disclosure, distribution or copying of this information is strictly prohibited.

The Kentucky Department of Agriculture does not discriminate on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, or marital or family status in employment of the provisions of services. Reasonable accommodations are provided upon request.

This OSP was prepared by _________________________________

Date______________

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Deadline for Renewals, March 1 I have attached the following documents:

Organic Certification Application

Applicable Fees (according to the Fee Schedule attached to the Application)

Flow chart

Facility Map

Organic Control Points document

Organic Product Profiles

Organic Product Labels

Pest management map of traps and monitors

Water test, if applicable

Appropriate MSDS, if applicable

Submit completed form, Application, Fees, and supporting documents to:

Kentucky Department of Agriculture

Certified Organic Program

111 Corporate Drive

Frankfort, KY 40601

Printed with State Funds

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Organic Product Profile

Applicant Year Please fill out the following information for each individual organic product seeking certification. Attach a copy of all labels used for this product. Attach a copy of all certified organic ingredient certificates.

Name of finished product

Projected total volume expected to produce this year:

This finished organic product is made with (check one):

a. 100% certified organic ingredients

b. 95 – 99% certified organic ingredients

c. 70 – 94% certified organic ingredients

d. Less than 70% certified organic ingredients

List all processing aids used in production of this product:

Labels: Do labels include a “Certified Organic by” statement? yes no Are all certified organic ingredients identified as such in the ingredients panel? yes no Is the USDA Organic seal unaltered? yes no Product Composition: Complete the information for all ingredients contained in this product. Please be

consistent in measurement format.

Ingredient Supplier Certified By Weight or volume used in

product batch

Use additional sheets if necessary. Does the composition vary? yes no if yes please explain

If water, salt and/or alcohol are used as ingredients, indicate weight or volume used in a product batch.

Water: Salt: Alcohol: